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Search Results: 1 - 10 of 241 matches for " Yasuhisa Fujino "
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The Significance of Angiotensin Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Use in Sudden Cardiac Death  [PDF]
Makoto Onodera, Satoshi Kikuchi, Yasuhisa Fujino, Yoshihiro Inoue, Yuji Fujita
International Journal of Clinical Medicine (IJCM) , 2017, DOI: 10.4236/ijcm.2017.88046
Abstract: Objectives: To investigate the relationship between the use of angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) and hyperkalemia in patients diagnosed with sudden cardiac death. Methods: We examined oral ACE inhibitor or ARB use among cardiopulmonary arrest patients brought by ambulance to our emergency room during a 5-year period from January 2012 to December 2016. The cause of death was determined to be sudden cardiac death, despite temporary return of spontaneous circulation after starting cardiopulmonary resuscitation. Subjects were dichotomized into 2 groups, those taking and those not taking an ACE inhibitor or ARB. Variables determined retrospectively included serum potassium, estimated glomerular filtration rate as an index of kidney function and time from cardiopulmonary arrest to return of spontaneous circulation. The Mann-Whitney U-test was used to compare continuous data, and the chi-square test to compare categorical data between groups. The results are expressed as the median plus range. Statistical significance was assumed at p < 0.05. Results: Thirty-five patients met the inclusion criteria. The mean age was 77.1 years (range, 35 - 93 years), and there were 26 males and 9 females. Eleven subjects were ACE inhibitor or ARB users, and 24 were non-users. The serum potassium level was significantly higher in users than non-users (median, 6.2 mEq/L (range, 4.5 - 10.0) vs. 5.2 mEq/L (range, 3.6 - 8.3); p = 0.001). The estimated glomerular filtration rate was significantly lower in users than non-users (median, 25.1 mL/min/1.73 m2 (range, 4.6 - 60.3) vs. 46.9 mL/min/1.73 m2 (range, 19.8 - 97.1); p = 0.009). There was no significant difference in time from cardiopulmonary arrest to return of spontaneous circulation between the 2 groups (median, 24 minutes (range, 3 - 111) vs. 29 minutes (range, 10 - 54); p = 0.355). Conclusion: It is possible that hyperkalemia induced by ACE inhibitor or ARB use is a cause of sudden cardiac death, especially in patients with chronic kidney disease.
Endoscopic Hemostasis of Nonvariceal Gastrointestinal Bleeding  [PDF]
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Hisaho Sato, Masahiro Kojika, Shigeatsu Endo
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.519147
Abstract: We investigated 2668 patients with non-variceal upper gastrointestinal bleeding and 660 patients with lower gastrointestinal bleeding treated between 1987 and 2011 in our hospital. Upper gastrointestinal bleeding was associated with gastric ulcer, duodenal ulcer, Mallory-Weiss syndrome, esophageal disease, and others. Endoscopic hemostasis was performed in approximately 67% of all cases with upper gastrointestinal bleeding and approximately 90% of cases with ulcer. The hemostasis success rate was over 90% for ulcer bleeding, and was also generally high for other diseases. The total number of patients with lower gastrointestinal bleeding was lower, with it being approximately 20% of those with upper gastrointestinal bleeding. Endoscopic hemostasis was performed in approximately 30% of the patients with lower gastrointestinal bleeding. The hemostasis success rate was generally high, but treatment switch to surgery or interventional radiology (IVR) was observed in some cases with colorectal diverticular bleeding.
A Study of Mallory-Weiss Syndrome Secondary to Upper Gastrointestinal Bleeding  [PDF]
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Hisaho Sato, Hironobu Noda, Masahiro Kojika, Yasushi Suzuki, Shigeatsu Endo
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.43021

Background: In Mallory-Weiss Syndrome (MWS), vomiting causes the mucous membrane and submucosa near the esophagogastric mucosal junction to tear and bleed. Thus, MWS can arise after heavy drinking and as a complication of endoscopic upper gastrointestinal examinations or procedures. However, there has been no report of MWS secondary to upper gastrointestinal bleeding thus far. Case Subjects: Of 79 MWS cases over a 10-year period from 2002 to 2011, we identified and studied 6 cases, in which MWS was probably caused by another lesion causing upper gastrointestinal bleeding. Results: There were 2 cases, each of gastric ulcers, duodenal ulcers, and varicose veins. In 3 cases, MWS was discovered during treatment of the primary lesion and was simultaneously treated. In the other 3 cases, patients were treated for MWS according to endoscopic diagnosis, and the primary lesion was overlooked; in these cases, the primary lesion was identified and treated after the bleeding recurred. One patient with cirrhosis died of hepatic failure. Conclusion: Care should be taken when dealing with MWS because it can occur as a result of vomiting caused by hematemesis or as a complication of endoscopic examination and treatment. When assessing MWS, other hemorrhagic lesions may be overlooked.

The East Japan Great Earthquake and Three Cases of Near-Drowning with Tsunami Due to the Earthquake  [PDF]
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Hisaho Sato, Hironobu Noda, Masahiro Kojika, Yasushi Suzuki, Shigeatu Endo
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.43023

We encountered the Great East Japan Earthquake on March 11, 2011. The magnitude of the earthquake is 9.0 and it is one of the greatest from A.D. 1900 to now. The earthquake developed large tsunami and many people living on the pacific coast of east Japan died from lung disorder caused by near drowning with tsunami. We also encountered three cases of lung disorders caused by near drowning. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal intubation and mechanical ventilation. All three died within three weeks. In at least two cases, misswallowing of oil was suspected from the features noted at the time of the detection. Many bacteria were detected from the phlegm of two cases.

A Case of Multiple Hemorrhagic Gastric Ulcers Developed via a Mechanism Similar to Water-Immersion Restraint Stress  [PDF]
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Hisaho Sato, Hironobu Noda, Masahiro Kkojika, Yasushi Suzuki, Shigeatsu Endo
Open Journal of Clinical Diagnostics (OJCD) , 2015, DOI: 10.4236/ojcd.2015.54022
Abstract: In rats, water-immersion restraint stress is a model of experimental ulceration. We encountered a case in which multiple hemorrhagic gastric ulcers formed in the stomach in a setting similar to water-immersion restraint stress. The patient was a 54-year-old man who was found wet on a riverbank and transported by ambulance. Because of hypothermia and renal failure, hemodialysis was performed. Tarry stools were noted and endoscopy revealed the presence of multiple hemorrhagic gastric ulcers; thus, hemostasis was performed end oscopically. During the course, pseudo membranous colitis also developed and was ameliorated with vancomycin. Further, the renal failure and gastric ulcers improved, and the patient was discharged from hospital 25 days later. The reason why he survived more than 2 weeks was the hot summer season and he was not soaked in the river water throughout.
Investigation of Patients with Spontaneous Rupture of the Urinary Bladder  [PDF]
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Hisaho Sato, Masahiro Kojika, Yasushi Suzuki, Gaku Takahashi, Shigehiro Shibata
Open Journal of Clinical Diagnostics (OJCD) , 2015, DOI: 10.4236/ojcd.2015.54023
Abstract: Non-traumatic rupture of the urinary bladder is termed “spontaneous rupture of the urinary bladder”. Although this disorder is relatively rare, when the bladder ruptures into the abdominal cavity, urine leaking into the abdominal cavity leads to the development of urinary peritonitis. We encountered seven patients with spontaneous rupture of the urinary bladder at our institution between 1987 and 2012. Six of these patients were women, all of whom had undergone surgery and radiotherapy to treat malignant uterine tumor. All seven patients suddenly developed abdominal pain and ascites. Urea nitrogen (UN) and creatinine (Cre) levels were greater in ascites than in the blood in all patients. Although all patients were treated conservatively, recurrence was identified in three patients. Recurrence was observed in only one of the four patients who received hyperbaric oxygen therapy. Conclusion: Hyperbaric oxygen therapy may be effective for recurrence of spontaneous rupture of the urinary bladder.
A Case of Secondary Aortoesophageal Fistula Inserted a Covered Self-Expanding Esophageal Stent to Control Gastrointestinal Bleeding
Makoto Onodera,Yoshihiro Inoue,Yasuhisa Fujino,Satoshi Kikuchi,Shigeatsu Endo
Case Reports in Gastrointestinal Medicine , 2013, DOI: 10.1155/2013/857135
Abstract: A 73-year-old man presented with melena. After a thorough workup including esophageal endoscopy, computed tomography scans, and esophagography, the diagnosis of secondary aortoesophageal fistula was made. Two years previously, he had undergone endovascular stent-graft repair for the dissection of his descending thoracic aorta. Because of the generally poor condition of the patient and the high risk of any aggressive surgical intervention, we inserted a covered self-expanding esophageal stent on postadmission day 18. Esophagography after insertion did not show any evidence of a leak of contrast medium. Despite treatment with antibiotics, he developed sepsis and expired on day 52, but rebleeding did not occur in this period. We consider insertion of a covered self-expanding esophageal stent as a feasible option in the management of secondary aortoesophageal fistula in high-risk patients. 1. Introduction Secondary aortoesophageal fistula (AEF) after thoracic endovascular aortic repair (TEVAR) is relatively rare [1–6], with a reported incidence of 1.7% to 1.9% [4, 7]. Treatment options are very limited, as these patients are usually not candidates for open surgery. Outcomes with conservative management are almost always fatal due to recurrent hemorrhage or chronic mediastinitis. Of note, there are no treatments to manage spontaneous, recurrent hemorrhage. In this paper, we describe a case of secondary AEF with insertion of a covered self-expanding esophageal stent to control gastrointestinal bleeding. 2. Case Presentation A 73-year-old man presented with melena. He had a history of endovascular stent-graft repair for the dissection of a descending thoracic aorta at the age of 71 and a stent-graft repair for a pseudoaneurysm sac of the distal aortic arch at the age of 72. He was hemodynamically unstable, and the bulbar conjunctiva showed evidence of anemia at presentation. Esophago-gastro-duodenoscopy (EGD) on admission revealed a white polyp in the midesophagus but no signs of acute bleeding. Colonoscopy was unremarkable. A blood transfusion failed to raise the hematocrit. On postadmission day five, the patient had hematemesis, prompting repeat EGD. Closer inspection of the previously seen esophageal polyp showed that the white material at the base was in fact the wall of the aortic interposition graft (Figure 1). Chest computed tomography (CT) scans revealed a high-density spot in contact with the esophagus and low-density spots in the vicinity of the stent graft. Esophagography showed a fistulous tract toward the stent graft (Figure 2). We concluded that
Balloon-occluded retrograde transvenous obliteration for gastric varices: the relationship between the clinical outcome and gastrorenal shunt occlusion
Kenichi Katoh, Miyuki Sone, Atsuo Hirose, Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera
BMC Medical Imaging , 2010, DOI: 10.1186/1471-2342-10-2
Abstract: B-RTO was performed in 47 patients with gastric varices, who were at a risk of variceal ruptures and who may or may not have had a history of variceal bleeding. We injected a sclerosing agent into the gastric varices for 30-60 minutes. To evaluate the therapeutic efficacy of the technique, we obtained contrast-enhanced computed tomography (CT) scans 5 days after B-RTO. As a general rule, if the gastric varices did not appear thrombosed, we repeated the procedure 7 days after the first procedure.B-RTO was a technical success in 37 patients. It was performed once in 26 patients, twice in 6 patients, thrice in 2 patients, and 4 times in 3 patients. Contrast-enhanced CT scans obtained after B-RTO showed thrombosed gastrorenal shunts in 29 patients and patent gastrorenal shunts in 8 patients. The gastric varices recurred in 2 patients who had patent gastrorenal shunts. The overall cumulative relapse-free rate of gastric varices was 90% at 5 years after B-RTO.B-RTO is an effective treatment modality for gastric varices. Moreover, obliteration of the gastrorenal shunt as well as the gastric varices appears to be important for the treatment of gastric varices.The rupture of gastric varices is associated with a mortality rate of 25-55% because it leads to extensive blood loss as compared to the blood loss because of the rupture of esophageal varices [1-4]. Because of poor liver function and rapid blood flow in patients with gastric varices, the development of effective treatment for this condition is a challenge. Gastric varices can be treated by endoscopic injection therapy with cyanoacrylate, but there is a risk of migration of this compound into systemic circulation through the inferior vena cava via the gastrorenal shunt [5]. Balloon-occluded retrograde transvenous obliteration (B-RTO), a minimally invasive procedure that was introduced in the mid-1990s, has been widely accepted in Japan. In the standard technique, gastric varices are thrombosed using a sclerosing agent
Performance Prospects of Fully-Depleted SOI MOSFET-Based Diodes Applied to Schenkel Circuit for RF-ID Chips  [PDF]
Yasuhisa Omura, Yukio Iida
Circuits and Systems (CS) , 2013, DOI: 10.4236/cs.2013.42024

The feasibility of using the SOI-MOSFET as a quasi-diode to replace the Schottky-barrier diode in the Schenkel circuit is examined by device simulations primarily and experiments partly. Practical expressions of boost-up efficiency for d. c. condition and a. c. condition are proposed and are examined by simulations. It is shown that the SOI-MOSFET-based quasi-diode is a promising device for the Schenkel circuit because high boost-up efficiency can be gained easily. An a. c. analysis indicates that the fully-depleted condition should hold to suppress the floating-body effect for GHz-level RF applications of a quasi-diode.

Simulation of a Daily Precipitation Time Series Using a Stochastic Model with Filtering  [PDF]
Chieko Gomi, Yasuhisa Kuzuha
Open Journal of Modern Hydrology (OJMH) , 2013, DOI: 10.4236/ojmh.2013.34025
Abstract: After we modified raw data for anomalies, we conducted spectral analysis using the data. In the frequency, the spectrum is best described by a decaying exponential function. For this reason, stochastic models characterized by a spectrum attenuated according to a power law cannot be used to model precipitation anomaly. We introduced a new model, the e-model, which properly reproduces the spectrum of the precipitation anomaly. After using the data to infer the parameter values of the e-model, we used the e-model to generate synthetic daily precipitation time series. Comparison with recorded data shows a good agreement. This e-model resembles fractional Brown motion (fBm)/fractional Lévy motion (fLm), especially the spectral method. That is, we transform white noise Xt to the precipitation daily time series. Our analyses show that the frequency of extreme precipitation events is best described by a Lévy law and cannot be accounted with a Gaussian distribution.
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